Robert Aghasaryan, MD
Individual provider Active NPI Family Medicine Physician · Des Moines, IA
NPI 1891483053 · NPPES record last updated May 16, 2023
Key facts
- NPI
- 1891483053
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- R-12695 (IA)
- Practice address
- 1111 6TH Ave
Des Moines, IA 50314-2613 - Phone
- (515) 643-2682
- Fax
- (515) 643-5802
- NPI assigned
- Apr 26, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230518003407 | IA | Order and Referring Only - Family Practice |
6406212307 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-12695 | IA | MD | Family Medicine Physician |
Interoperability endpoints
- raghasaryan657239@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R-12695 | IA | Yes |
Addresses
Primary practice location
1111 6TH Ave
Des Moines, IA 50314-2613
Mailing address
PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-2682
Other providers in Des Moines, IA
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- Alexandra Agostini
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All providers in Des Moines, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.